A comparison of six different ways of expressing the bronchodilating response in asthma and COPD; reproducibility and dependence of prebronchodilator FEV1

Various indices are used to express the bronchodilating response. It is unclear, however, which index is most informative. The aim of this study was to compare six expressions of the bronchodilating response and to examine: 1) the independence of the prebronchodilator forced expiratory volume in one second (FEV1); and 2) the reproducibility of the bronchodilating response. Bronchodilating responses (increases in FEV1 60 min after salbutamol 400 micrograms and ipratropium bromide 80 micrograms) on six test occasions, during two years, of 183 patients (72 asthma, 111 chronic obstructive pulmonary disease (COPD)) from a large bronchodilator intervention study were used. The dependence of the prebronchodilator FEV1 was investigated both between patients (cross-sectional analysis) and within patients (longitudinal analysis) by means of linear regression analysis. The reproducibility of the bronchodilating response was calculated by means of the coefficients of variation (CVs) of the six bronchodilating responses during two years. The CVs of the six expression indices were compared by analysis of variance (ANOVA). No index was independent of the prebronchodilator FEV1. However, some indices were significantly more dependent on the prebronchodilator lung function and, therefore, less reproducible than others. The "% initial" index (change as a percentage of the prebronchodilator value) was the most dependent on the prebronchodilator lung function and had the worst reproducibility (CV ranged from 50-61%). The "% possible" (change as a percentage of the predicted minus prebronchodilator value) and "% achievable" (change as a percentage of the maximal postbronchodilator minus prebronchodilator value) indices were the least dependent on the prebronchodilator value and had the highest reproducibility (CV ranging from 34-53%).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				A. Kainu, A. Lindqvist, S. Sarna, B. Lundback, and A. Sovijarvi FEV1 Response to Bronchodilation in an Adult Urban Population Chest, August 1, 2008; 134(2): 387 - 393. [Abstract] [Full Text] [PDF]

				B J Smith, S L Appleton, A J Veale, H J McElroy, D Veljkovic, and L Saccoia Eformoterol n-of-1 trials in chronic obstructive pulmonary disease poorly reversible to salbutamol Chronic Respiratory Disease, April 1, 2004; 1(2): 63 - 69. [Abstract] [PDF]

				N J Gross Responses to steroids and bronchodilators in COPD in the ISOLDE trial: the fat lady sings on Thorax, August 1, 2003; 58(8): 647 - 648. [Full Text] [PDF]

				P M A Calverley, P S Burge, S Spencer, J A Anderson, and P W Jones Bronchodilator reversibility testing in chronic obstructive pulmonary disease Thorax, August 1, 2003; 58(8): 659 - 664. [Abstract] [Full Text] [PDF]

				L. J. Palmer, J. C. Celedon, H. A. Chapman, F. E. Speizer, S. T. Weiss, and E. K. Silverman Genome-wide linkage analysis of bronchodilator responsiveness and post-bronchodilator spirometric phenotypes in chronic obstructive pulmonary disease Hum. Mol. Genet., May 15, 2003; 12(10): 1199 - 1210. [Abstract] [Full Text] [PDF]

				D. Tashkin and S. Kesten Long-term Treatment Benefits With Tiotropium in COPD Patients With and Without Short-term Bronchodilator Responses Chest, May 1, 2003; 123(5): 1441 - 1449. [Abstract] [Full Text] [PDF]

				C. DELACOURT, H. LORINO, C. FUHRMAN, M. HERVE-GUILLOT, P. REINERT, A. HARF, and B. HOUSSET Comparison of the Forced Oscillation Technique and the Interrupter Technique for Assessing Airway Obstruction and Its Reversibility in Children Am. J. Respir. Crit. Care Med., September 15, 2001; 164(6): 965 - 972. [Abstract] [Full Text] [PDF]

				E Dompeling, A M Oudesluys-Murphy, H M Janssens, W Hop, J G Brinkman, R N Sukhai, and J C de Jongste Randomised controlled study of clinical efficacy of spacer therapy in asthma with regard to electrostatic charge Arch. Dis. Child., February 1, 2001; 84(2): 178 - 182. [Abstract] [Full Text]

				T. NIU, J. J. ROGUS, C. CHEN, B. WANG, J. YANG, Z. FANG, S. T. WEISS, and X. XU Familial Aggregation of Bronchodilator Response . A Community-Based Study Am. J. Respir. Crit. Care Med., November 1, 2000; 162(5): 1833 - 1837. [Abstract] [Full Text]

				C. DELACOURT, H. LORINO, M. HERVE-GUILLOT, P. REINERT, A. HARF, and B. HOUSSET Use of the Forced Oscillation Technique to Assess Airway Obstruction and Reversibility in Children Am. J. Respir. Crit. Care Med., March 1, 2000; 161(3): 730 - 736. [Abstract] [Full Text] [PDF]

				P. M. Dorinsky, C. Reisner, G. T. Ferguson, S. S. Menjoge, C. W. Serby, and T. J. Witek Jr. The Combination of Ipratropium and Albuterol Optimizes Pulmonary Function Reversibility Testing in Patients With COPD Chest, April 1, 1999; 115(4): 966 - 971. [Abstract] [Full Text] [PDF]